Liang Hui, Guan Wei, Yang Yanling, Mao Zhongqi, Mei Yijun, Liu Huan, Miao Yi
Department of General Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China;
Department of General Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China;
J Biomed Res. 2015 Apr;29(2):112-7. doi: 10.7555/JBR.29.20140109. Epub 2015 Jan 25.
Roux-en-Y gastric bypass surgery (RYGB) has been demonstrated to be successful for treating type-II diabetes mellitus (T2DM) patients with a body mass index (BMI) <30 kg/m(2), but reports of RYGB for T2DM patients with a BMI <28 kg/m(2) are lacking. T2DM patients with a BMI <28 kg/m(2) were prospectively recruited to participate in this study in four hospitals. The endpoint was T2DM remission (defined by fasting blood glucose (FBG) level <110 mg/dL and hemoglobin (Hb)A1c level <6.0% at 12 months postoperatively). Predictors of remission were investigated by univariate and multivariate analyses. Eighty-six patients were assessed. Eighty-five patients underwent RYGB, with one conversion to open surgery. We compared the values of various variables before and after surgery. The mean BMI decreased from 24.68±2.12 to 21.72±2.43 kg/m(2) (P<0.001). Fifty-eight (67.4%) patients were not treated by drugs or insulin after surgery, and 20 patients (23.3%) had complete remission of T2DM at 12 months after surgery with an acceptable number of complications. The mean HbA1c level in the remission group was significantly lower than that in the non-remission group. Patients with a higher weight, lower HbA1c level, higher C-peptide level, and higher FBG level were more likely to have T2DM remission in multivariate analyses. In conclusion, RYGB was effective and safe for treating T2DM patients with a BMI <28 kg/m(2). Complete remission can be predicted by cases having a higher weight, lower HbA1c level, higher C-peptide level, and higher FBG level.
Roux-en-Y胃旁路手术（RYGB）已被证明对于治疗体重指数（BMI）<30kg/m²的2型糖尿病（T2DM）患者是成功的，但缺乏关于BMI<28kg/m²的T2DM患者接受RYGB手术的报道。前瞻性招募了BMI<28kg/m²的T2DM患者在四家医院参与本研究。终点为T2DM缓解（定义为术后12个月时空腹血糖（FBG）水平<110mg/dL且糖化血红蛋白（Hb）A1c水平<6.0%）。通过单因素和多因素分析研究缓解的预测因素。对86例患者进行了评估。85例患者接受了RYGB手术，其中1例转为开放手术。我们比较了手术前后各种变量的值。平均BMI从24.68±2.12降至21.72±2.43kg/m²（P<0.001）。58例（67.4%）患者术后未接受药物或胰岛素治疗，20例（23.3%）患者在术后12个月时T2DM完全缓解，且并发症数量可接受。缓解组的平均HbA1c水平显著低于未缓解组。在多因素分析中，体重较高、HbA1c水平较低、C肽水平较高和FBG水平较高的患者更有可能实现T2DM缓解。总之，RYGB对于治疗BMI<28kg/m²的T2DM患者是有效且安全的。体重较高、HbA1c水平较低、C肽水平较高和FBG水平较高的病例可预测完全缓解。
